Early adiposity rebound and the risk of adult obesity
Early adiposity rebound and the risk of adult obesity
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DOI：
10.1542/peds.101.3.e5
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发表时间：
1998-03-01
期刊：
影响因子：
8
通讯作者：
Dietz, WH
中科院分区：
文献类型：
--
作者：
Whitaker, RC;Pepe, MS;Dietz, WH
Objective.在5至6岁时，身体脂肪通常会下降到最低点，称为肥胖反弹（AR），然后再次增加到成年期。我们确定AR时年龄较小是否与成人肥胖风险增加相关，以及这种风险是否与AR时的肥胖和父母肥胖无关。一项回顾性队列研究，使用门诊病历中记录的终身身高和体重测量结果。普吉特海湾团体健康合作社（GHC），一个总部设在华盛顿州西雅图的健康维护组织。1965年1月1日至1971年1月1日期间在GHC出生的所有390名GHC成员（及其父母），他们至少有一次记录的成人身高和体重测量，加上两次在三个年龄段（1.5至4岁，4至8岁和8至16岁）的身高和体重测量记录。我们计算了每个受试者在年轻成年期（21至29岁）的平均体重指数（BMI），以及每个受试者1.5岁时父母的BMI。成人肥胖定义为男性BMI大于或等于27.8，女性BMI大于或等于27.3。将曲线拟合到年龄在1.5至16岁之间的每个受试者的BMI值，并根据这些曲线计算AR时的年龄和BMI。受试者被分为AR时的年龄（早期、中期和晚期）、AR时的BMI和父母BMT（重、中、瘦）三分位数。AR时的平均年龄为5.5岁，15%的队列在年轻时肥胖。成人肥胖率在早期AR与晚期AR（25%与5%），AR时体重与瘦体重（24%与4%），母亲体重与瘦体重（25%与5%），以及父亲体重与瘦体重（21%与5%）中较高。校正父母BMI和AR时BMI后，成人肥胖与早期AR和晚期AR相关的优势比为6.0（95%CI，1.3-26.6）。早期AR与成人肥胖风险增加相关，与父母肥胖和AR时的BMI无关。未来的研究应该检查AR的生物学和行为决定因素。
Objective. At 5 to 6 years of age, body fatness normally declines to a minimum, a point called adiposity rebound (AR), before increasing again into adulthood. We determined whether a younger age at AR was associated with an increased risk of adult obesity and whether this risk was independent of fatness at AR and parent obesity.Design. A retrospective cohort study using lifelong height and weight measurements recorded in outpatient medical records.Setting. Group Health Cooperative of Puget Sound (GHC), a health maintenance organization based in Seattle, Washington.Participants. All 390 GHC members (and their parents) born at GHC between January 1, 1965, and January 1, 1971, who had at least one recorded adult height and weight measurement plus two visits with recorded height and weight measurements in each of three age intervals: 1.5 to 4, 4 to 8, and 8 to 16 years.Main Outcome Measures. We calculated the mean body mass index (BMI) of each subject during young adulthood (age 21 to 29 years) and the BMI of the parents when each subject was 1.5 years of age. Adult obesity was defined as a BMI greater than or equal to 27.8 for males and greater than or equal to 27.3 for females. Curves were fit to each subject's BMI values between ages 1.5 and 16 years, and the age and BMI at AR were calculated from these curves. Subjects were divided into tertiles of age at AR (early, middle, and late), BMI at AR, and parent BMT (heavy, medium, and lean).Results. The mean age at AR was 5.5 years, and 15% of the cohort was obese in young adulthood. Adult obesity rates were higher in those with early versus late AR (25% vs 5%), those who were heavy versus lean at AR (24% vs 4%), those with heavy versus lean mothers (25% vs 5%), and those with heavy versus lean fathers (21% vs 5%). After adjusting for parent BMI and BMI at AR, the odds ratio for adult obesity associated with early versus late AR was 6.0 (95% CI, 1.3-26.6).Conclusion. An early AR is associated with an increased risk of adult obesity independent of parent obesity and the BMI at AR. Future research should examine the biological and behavioral determinants of AR.